Silicone implants from the 1980's?

Question

My breast augmentation for appearance only was back in the 1980's. They were silicone back then. What possible health hazards am I faced with? They still look great even though one is firmer than the other. Should I replace them, because frankly I cant afford it, but I will if they are dangerous. From what Ive read there are really no real health issues to worry about. I would like to get an MRI to better check my breasts once a year for a mammogram becsause they are dense when x-rayed.

Robert F. Centeno, MD, FACS · Answer

The FDA approved silicone implants for primary breast augmentation because the data showed that they are safe.  If you are still pleased with the cosmetic outcome, there is no reason to replace them.  In terms of monitoring your breast health, digital mammography using the Eklund implant displacement technique is the most appropriate test.  Regularannual  breast examination by your primary doctor, OB/GYN or Plastic Surgeon would also be appropriate. All the best.

Kenneth Hughes, MD · Answer

If one breast is harder than the other, you should be checked for capsular contracture.  In addition, an MRI may be appropriate to check for rupture.  If they are ruptured, they should be replaced.

Jourdan Gottlieb, MD · Answer

If there is no reason to remove the implants, I wouldn't recommend doing so. In my community the MRI can set you back about $2000, so you may want to think twice, since your insurer is not likely to cover the expense. The health hazards are minimal, verified in numerous studies done before the gel implants were allowed back on the market. 

	The firmness is a sign of capsular contracture, not of rupture itself, though rupture can be a cause. Best bet would be a consultation with a plastic surgeon. Also acceptable is a discussion with your primary physician. 

	Thanks for your question, best wishes.

Curtis Wong, MD · Answer

do not need to be replaced if you are happy with how things are for you. If you look with an MRI and your implant is ruptured, the recommendation will be for replacement. So don't look unless you want to consider replacing them. The capsule that formed around your original implant will contain any silicone unless you are involved in some high impact trauma to your chest.

Simone Matousek, FRACS (Plast), PhD, MBBS (Hons) · Answer

Silicone leak (except from the recently recalled PIP implants) is not dangerous; silicone is used in joint replacements and other medical devices.

	Breast implants from the 1980s had thinner shells and much more liquid silicone than is used today.

	The silicone used in implants now is much firmer; if you cut through the centre of an implant today, it looks like cutting through a "jelly baby").

	If the silicone leak is contained within the scar tissue that forms around the breast implant (capsule) it just remains adjacent to the original implant. If the silicone leak migrates past this (less commonly), it can end up in lymph glands in the armpit or in the surrounding tissues such as muscle. In these cases, it can cause cause symptoms (such as swelling in the armpit glands) and discomfort as well as a poor appearance. Whilst this is not dangerous, it may be uncomfortable.

	All implants I have removed from the 1980s have some degree of leak, usually it is contained, sometimes it is in the surrounding tissues (making surgical removal more challenging).

	Once again to emphasise it is not dangerous, however, many people do not like the appearance of their implant. 1980s implants had a much higher rate of capsular contracture (scar tissue around the implant causing it to feel firm and look distorted) than the implants we use today.

	I would say implants, even today with more durable shells and firmer silicone, are not a lifetime device. Exchange, however, is usually more for cosmetic appearance rather than safety.

	If your implants look great, and don't bother you, I would leave them. I suspect if you do get an MRI, there will almost definitely be some type of leak from such an old implant, however, it is not unsafe to leave them alone.

Steven Wallach, MD · Answer

I think you already answered your own question. You do not want to change them. If the firmness bothers you then you probably have a significant capsular contracture which would warrant removal and exchange.

Terry A. Cromwell, MD (retired) · Answer

The breast that has become firmer is more likely to have a ruptured implant. The best test is an M.R.I. If there is a rupture the implants need to be removed, and If you wish replaced. If there is no rupture then leave well enough alone.

Silicone implants from the 1980's?

Answers (7)

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